3. classification of bone fractures

Why’s a bone go from thick to thin

less stress near the top

Fracture definition

a break in one cortex, exiting from the opposite cortex (cortex being outer layer btw)

what does a twisting force on the bone make

spinal fracture w a long fracture line OR an oblique fracture w short fracture line

What’s a bending force on the bone make

a transverse fracture w a 3rd small fragment called a bending wedge

what’s a high energy force make

comminated fracture w lots of fragments

how to classify a bone, basically

• what bone

• what’s wrong w the bone

• what sort of fracture on the bone

• mechanism of injury

• name, DOB, etc

3 levels of severity of displacements

GOOD

BAD

UGLY

GOOD displacement

minimally displaced

heals well

bone still gets supplied

BAD displacement

shattered shaft

difficult but will heal

little chance of osteoarthritis as the joint’s preserved

UGLY displacement

joint disurpted

long term osteoarthritis

needs replacement

Steps to AO Classification

1. number the commonly fractured bones in the skeleton

2. find where it’s fractured

3. look at the type of fracture

4. If near, into the joints, differentiate that too

Label the soft tissues around the bone

1. skin

2. muscle

3. blood vessels

4. nerves

5. tendon/ligamanet

6. fascia

7. bone

closed vs open fracture

closed means the skin’s intact. open means it aint

issues w open fracture

high risk of infection, non-union of the bone, potentially leads to osteomyelitis

When reading an x-ray, you BETTER READ

• name of the patient

• confirm dob w the patient and their wristband

• hospital number

• date of x-ray

• note part of the region, right or left

• look for if the x-ray’s standing or weight bearing

angulation of limb; two types

Varus or valgus

varus

“VARUS A PIG” between your legs

• apex lateral

• distal limb towards midline bow leg

Valgus

• apex medial

• distal limb away from midline

• knock knees

What’s webber classification for

Ankle fractures- either A, B or C

What’s garden classification for

Hip fractures

two type of hip joint fractures

Intracapsular

intertrochanteric

What’s the difference between intracapsular and intertrochanteric

Intracapsular ruptures the blood vessels supplying stuff to the femoral head. intertrochanteric doesn’t.

How does the femoral head heal w intracapsular fracture

it don’t. even if fixed. it WILL DIE

How to treat an intracapsular fracture

replace the fractured bones w a hemiarthroplasty that replaces the femoral head

how long till operation in elderly ppl

36 hrs

What are salter-harris fractures

fractures in children, ranging from alright to you’re screwed

how long till a hip operation for kiddies

6 hrs

risks w hip fractures & kiddies

some may develop avascular necrosis, and will need a total hip replacement then.

How are intertrochanteric fractures fixed

dynamic hip screw

differences of intertrochanteric fracture treatment w ages

nah all the same